Tinnitus can be one of the most frustrating and disturbing disorders that one can experience. While many would say they experience tinnitus, a smaller but significant percentage of those with tinnitus truly suffer from it. Tinnitus is not a disease. Tinnitus does not cause hearing loss, but tinnitus can be associated with hearing loss. One can also have tinnitus even if they have normal hearing. Tinnitus has been defined by the American Tinnitus Association as the "perception of sound when no actual external noise is present. While it is commonly referred to as "ringing in the ears," tinnitus can manifest many different perceptions of sound, including buzzing, hissing, whistling, swooshing, and clicking. In some rare cases, tinnitus patients report hearing music. Tinnitus can be both an acute (temporary) condition and a chronic (ongoing) health malady."
Sensorineural hearing loss is often associated with tinnitus. The incidence of tinnitus rises with age. Tinnitus has also been associated with metabolic disorders such as diabetes, autoimmune disorders, blood vessel disorders, head and neck trauma, and ototoxic medications. Additionally, it has been associated with traumatic brain injury and other medical conditions.
When seeking treatment for tinnitus management, a medical evaluation is required to rule out any treatable medical conditions associated with the tinnitus. Our approach to tinnitus management at North Shore Audio-Vestibular Lab is individualized to provide optimal intervention. While it is true that at this point in time there is no blanket cure for tinnitus, there are many things that can be done to ameliorate the negative effects of the tinnitus. Successful treatment requires a comprehensive tinnitus evaluation to identify potential etiology of the tinnitus and interventional options.
Dr. Meltzer is a member of the Tinnitus Retraining Therapy Association (TRTA) and has trained with Dr. Pawel Jastreboff who first described the neurophysiological model of tinnitus in 1990. He estimates that tinnitus affects about 17% of the general population around the world. So, tinnitus is certainly not a rare complaint. Of those with clinically significant tinnitus, some decreased tolerance to sound (DST) is experienced by about 40%. For some the DST can be a serious problem and for others it is mild. Hyperacusis is the name for a significant decreased tolerance to sound. Just as tinnitus can have various levels of severity, so can hyperacusis. The Hyperacusis Network has some very helpful information about decreased sound tolerance and recommendations for treatment.
Misophonia is a specific form of hyperacusis. Misophonia is the term coined by Dr. Pawel Jastreboff and Dr. Margaret Jastreboff in about 2000. It had previously been described by Dr. Marsha Johnson (audiologist) as 4S: Selective Sound Sensitivity Syndrome (hence 4S). Misophonia is often self-diagnosed and we can thank the internet for this. Misophonia is a strong dislike or hatred of specific sounds. It is often a sound associated with the face or body noises such as chewing, sniffling, lip smacking, gum chewing, etc. These events that cause such negative emotional reactions are referred to as triggers. Triggers can be auditory, visual, olfactory, tactile, but are always immediate and severely negative. The emotions most often associated with exposure to triggers are anger, disgust, and the need to flee the situation. These are reflexive responses. Onset of Misophonia seems to be common between the ages of 8 and 12 years of age and seem to affect more females than males.